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The  Supposed  Death-rates  of  abstainers 

AND  Non-Abstainers  and  Their 

Lack  of  Scientific  Value 


O 
CM 

d 


The  Supposed  Death=Rates  of  Abstainers 

AND   N0N=ABSTA1NERS   AND   THEIR 

Lack  of  Scientific  Value 


BY 


EDWARD  BUNNELL  PHELPS,  M.A.,  F.S.S. 

Editor,  THE  AMERICAN  UNDERWRITER,  of  New  York  City,  and  Author  of  "Tropical 

Hazards,"  "American  Mortality  Statistics  for  the  Nine  Years,  1900-1908,"  "Neurotic 

Books  and  Newspapers  as  Factors  in  the  Mortality  of  Suicide  and  Crime," 

"The  Mortality  of  Alcohol,"  "The  Mortality  from  Alcohol 

in  the  United  States,"  etc. 


Reprinted  from 

THE  AMERICAN  UNDERWRITER  MAGAZINE  AND  INSURANCE  REVIEW 
Vol.  XL,  No.  I  (July,  I9I3) 


NEW    YORK 

THRIFT   PUBLISHING   COMPANY 

1913 


Q 


The  Supposed  Death=Rates  of  Abstainers 

AND  N0N=ABSTAINERS  AND  THEIR 

Lack  of  Scientific  Value 


AFTER  a  study  of  all  available  data  on  the  subject,  about 
two  years  ago  I  comiJiled  and  published  under  the  title 
of  "The  Mortality  of  Alcohol"  a  tentative  statistical  approxi- 
mation of  the  adult  mortality  of  the  United  States  in  which 
alcohol  possibly  might  figure  as  a  causative  or  contributory 
factor.  My  findings  were  based  upon  the  independent  percentage 
estimates  for  each  of  io6  causes  of  deaths  kindly  made  for  me 
by  the  Medical  Directors  of  three  well-known  American  insur- 
ance companies.  The  book  by  no  means  purported  to  have 
solved  the  complex  problem  with  which  it  dealt  but  was  offered 
merely  as  a  possible  starting-point  for  detailed  scientific  dis- 
cussion of  the  actual  relations  of  alcohol  and  adult  mortality  in 
this  country.  It  was  so  accepted  by  the  leading  medical  journals, 
and  was  generally  received  by  the  reviewers  as  a  pioneer  effort  in 
its  field.  Since  the  publication  of  this  preliminary  study— or  first 
aid  to  the  injured,  very  much  injured,  facts  in  the  case— I  have 
endeavored  to  keep  track  of  the  contemporaneous  literature  of 
the  subject,  and  to  collect  all  serious  contributions  to  the  dis- 
cussion of  the  relations  of  alcohol  and  human  mortality. 

The  more  T  have  collected,  and  read  and  thought  on  the 
subject,  the  more  I  have  been  impressed  with  the  widespread 


270236 


:-2  ■  DMATH-R'ATBSdP  ABSTAIN URS  AND  NON-ABSTAINERS 

circulation  of  misleading  figures,  and  conclusions  as  to  the 
alleged  death-rates  of  users  and  non-users  of  alcohol  which  in 
my  judgment  seem  to  be  unwarranted.  The  reading  of  the  text 
of  a  discussion  of  the  subject  before  the  Association  of  Life 
Insurance  Medical  Directors  of  America,  in  the  recently-pub- 
lished transactions  of  that  important  body  for  the  years  1906- 
191 1,  has  shown  that  at  least  some  competent  observers  concur 
with  my  views  of  the  unreliability  of  many  of  the  figures  and 
conclusions  on  these  lines.  And  it  has  therefore  seemed  worth 
while,  in  the  interest  of  a  sober  discussion  of  this  phase  of 
modern  vital  statistics,  to  endeavor  to  present  herewith  and 
calmly  weigh  the  figures  and  supposed  facts  which  of  late  years 
have  been  repeatedly  cited  as  bearing  on  the  alleged  difference 
between  the  death-rates  of  abstainers  and  non-abstainers. 

That  there  is  a  difference  between  the  death-rates  of  the  two 
sections  of  the  community  loosely  grouped  as  "drinkers"  and 
"non-drinkers"  is  extremely  probable — in  fact,  practically  cer- 
tain. A  similar  statement  might  safely  be  made  of  fat  men  and 
lean  men,  tall  men  and  short  men,  ministers  and  lawyers,  physi- 
cians and  bookkeepers,  stone  masons  and  cabinet-makers,  and 
almost  innumerable  other  distinctive  groups  of  men.  As  to  the 
truth  of  this  sweeping  generalization,  there  is  not  the  slightest 
doubt;  confirmations  strong  as  proofs  of  holy  writ  are  to  be 
found  in  the  great  mass  of  tabulated  classifications  of  life  in- 
surance experience  for  the  last  fifty  years  and  more,  and  the 
carefully-kept  vital  statistics  of  England,  Germany  and  some 
other  countries  for  long  stretches  of  years. 

But — and  in  the  case  in  point  this  short  word  is  one  of 
momentous  importance — how  can  there  possibly  be  a  scientific 
determination  of  the  difference  between  the  death-rates  of  any 
two  groups  of  men  until  there  has  been  an  agreement  as  to 
the  precise  boundaries  of  the  groups?  In  other  words,  how 
can  the  difference  between  the  death-rates  of  users  and  non- 
users  of  alcohol  be  even  approximately  calculated  until  there 
has  been  a  separation  of  the  sheep  and  the  goats,  so  to  speak, 
that  is,  the  non-drinkers  and  the  drinkers  in  the  community 
under  observation?  Until  there  has  been  a  meeting  of  minds 
on  definitions  of  these  groups  it  is  no  more  possible  to  fix 
the  death-rates  of  the  two  groups  and  the  difference  between 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS   3 

them  than  it  is  to  engage  in  rational  argument  without  a  prior 
agreement  on  certain  premises.  This  prerequisite  for  scientific 
computation  of  the  relative  death-rates  of  the  two  groups  above 
named  apparently  has  not  occurred  to  the  vast  majority  of  the 
people  who  have  rushed  into  the  discussion  of  the  subject  in 
books,  and  periodicals,  and  pulpits,  and  in  the  avalanche  of 
Prohibition  literature  which  has  swept  over  this  country  of 
recent  years. 

NOT  the;  soundest  of  bases,  but  a  quicksand 

Aside  from  the  ultra  enthusiastic  anti-alcoholics,  whose  emo- 
tional embrace  of  the  subject  precludes  any  serious  considera- 
tion for  mere  facts  and  figures,  the  bulk  of  the  participants  in 
the  discussion  have  plainly  been  inclined  to  regard  as  the  sound- 
est of  bases  for  their  argument  and  conclusions  the  alleged  life 
insurance  experience  with  so-called  total  abstainers  and  non- 
abstainers.  On  the  strength  of  twenty  years'  somewhat  intimate 
acquaintance  with  the  statistics  of  the  insurance  business,  I  can 
only  regard  this  supposed  base  as  a  mere  quicksand  in  so  far  as 
trustworthy  evidence  of  the  actual  difference  between  the  death- 
rates  of  users  and  non-users  of  alcohol  is  concerned.  There  is 
quite  an  array  of  life  insurance  figures  which  conclusively  prove 
a  difference  between  the  death-rates  of  persons  insured  in  the 
abstaining  and  non-abstaining  classes,  but  after  a  thorough  study 
of  all  available  data  on  these  lines  I  am  satisfied  that  no  com- 
petent and  unbiased  person  who  has  carefully  examined  these 
figures  will  conclude  that  they  by  any  means  prove  either  one 
of  the  two  points  so  vehemently  advanced  by  the  Prohibition 
spokesmen,  namely,  ( i )  that  they  establish  the  actual  difference 
between  the  death-rates  of  drinkers  and  non-drinkers,  and  (2) 
that  they  afford  a  mathematical  measure  of  the  mortality  directly 
chargeable  to  the  use  of  alcohol.  '  Of  course  I  do  not  for  a 
moment  expect  that  I  can  convince  my  Prohibitionist  friends 
of  either  of  these  negative  deductions.  It  is  no  easy  matter  to 
prove  any  negative,  and  to  establish  to  the  satisfaction  of  the 
average  Prohibitionist  the  unsoundness  of  any  one  of  his  pet 
arguments  is  hopeless.  I  am,  however,  quite  ready  to  rest  with 
any  unbiased  reader,  or  competent  student  of  statistics,  the 
soundness  of  my  deductions  from  the  evidence  below  pre- 
sented. 


4    DBA  TH-RA TBS  OF  ABSTAINERS  AND  NON-ABSTAINBRS 

At  the  Twenty-second  Annual  Meeting  of  the  Association 
of  Life  Insurance  Medical  Directors  of  America,  held  at  New 
York  City  in  October,  191 1,  Dr.  T.  F.  McMahon,  medical  direc- 
tor of  the  Manufacturers'  Life  Insurance  Company,  of  Toronto, 
presented  a  paper  on  "The  Use  of  Alcohol  and  the  Life  Insur- 
ance Risk,"  and  included  in  his  paper  certain  figures  showing 
the  mortality  experience  of  some  English  life  insurance  com- 
panies with  separate  classes  of  so-called  abstaining  and  non- 
abstaining  policyholders,  which  are  discussed  on  subsequent 
pages  of  this  paper.  Dr.  McMahon's  address  was  followed  by  a 
general  discussion  of  the  subject  by  members  of  the  Association 
of  Medical  Directors,  and  in  part  the  report  of  the  discussion 
reads  as  follows: 

Dr.  Dwight  (Medical  Director  of  the  New  England  Mutual  Life)  — 
I  have  made  out  some  figures  in  the  experience  of  our  Company 
which  I  think  may  be  worth  while  calling  to  your  attention.  I  am 
sure  that  we  have  all  been  interested  in  the  figures  that  have  been 
given,  and  I  am  sure  that  there  can  be  no  question  as  to  the  accuracy 
of  such  figures,  but  /  am  equally  sure  that  if  such  figures  are  published 
without  some  qualification,  they  are  apt  to  give  a  false  impression,  and 
they  are  apt  to  be  accepted  by  certain  portions  of  the  community  at 
an  unfair  valuation.  I  am  sure  that  most  of  you  gentlemen  appre- 
ciate the  importance  of  having  your  classes  homogeneous,  and  this 
particular  investigation  shows,  I  think,  the  value.  There  are  many 
more  factors,  I  think,  than  the  one  question  as  to  whether  an  indi- 
vidual drinks  or  not,  which  should  be  taken  into  consideration.  I 
imagine  the  mortality  of  the  total  abstainer  in  the  Presbyterian  clergy- 
man class  and  the  total  abstainer  in  the  bartender  class  would  be  quite 
different,  and  included  in  these  large  groups  are  a  great  many  cases 
which  are  influenced  by  habitat,  other  habits,  occupation,  residence, 
type  of  life,  and  many  other  factors. 

I  am  not  going  to  take  up  much  of  your  time,  but  I  have  before  me 
figures  on  habits  in  our  Company  for  the  past  sixty  years,  both  on  liquor 
and  tobacco.  I  bring  them  up  to  show  two  or  three  rather  interesting 
points.  In  the  first  place  our  figures  on  the  habits  as  to  the  use  of  alco- 
hol agree  almost  exactly  with  those  which  have  been  given  us.  We  di- 
vide them  into  four  classes.  No  man  acknowledges,  or  very  few  men 
acknowledge,  that  they  are  excessive  in  the  use  of  liquor.  We  divide 
them  into  the  Total  Abstainer,  Rarely  Use,  Temperate,  and  Moderate. 
By  "rarely  use"  we  mean  the  man  who  says  that  he  perhaps  twice  a 
year  at  a  dinner  drinks  two  glasses  of  champagne.  While  we  have 
every  reason  to  believe  that  this  is  an  honest  statement,  it  is  not 
quite  fair  to  say  he  is  a  total  abstainer.  Otherwise  they  are  di- 
vided   by     the     individual's     own     statement — in     many     instances     in- 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS   5 

correct.  In  many  instances  the  total  abstainer  is  a  total  abstainer 
because  he  has  to  be  and  has  been  advised  to  be,  but  take  them 
as  they  run,  we  find  the  total  abstainer  with  a  mortality  of  59% 
of  the  American  Table— these  are  rough  figures;  Rarely  Use,  71%; 
Temperate,  84%;  and  Moderate,  125%.  If  we  let  these  figures  stand 
as  they  are,  it  is  accumulative  evidence  to  demonstrate  that  we  ought 
all  to  stop  drinking  the  next  minute,  and  that  we  ought  to  divide  our 
applicants  into  abstainers  and  non-abstainers;  but  let  us  see  what  the 
effect  of  tobacco  is.  We  find  that  the  total  abstainer  from  tobacco 
has  a  mortality  of  57%  as  against  59%  when  he  is  a  total  ab- 
stainer from  alcohol;  that  the  Rarely  Use  is  72%  as  against 
71%  from  alcohol;  that  the  Temperate  is  84%  as  against  84%  for 
alcohol;  and  that  the  Moderate  is  93%  as  against  125%  for  alcohol. 
In  other  words,  the  mortality  on  the  total  abstainer  from  alcohol  is 
almost  absolutely  the  same  as  that  on  the  total  abstainer  from  tobacco. 
It  may  be  said  that  a  man  is  usually  a  total  abstainer  from  both,  but 
he  is  not  necessarily  so.  It  does  mean,  I  think,  that  we  are  describ- 
ing the  same  kind  of  groups,  the  same  type  of  man,  the  same  con- 
servative type  of  man  in  the  total  abstainers  from  both  kinds.  Then 
to  show  you  the  numbers — we  find  that  out  of  180,000  cards,  42,700 
were  total  abstainers  from  alcohol — at  least  they  said  they  were — 
while  the  total  abstainers  from  tobacco  were  41,100 — almost  exactly 
the  same  number,  13,000  rarely  used  tobacco,  while  20,000  rarely  used 
alcohol.  /  only  bring  them  up  as  they  are,  simply  as  a  suggestion  that 
before  we  accept  all  total  abstainers  on  a  different  premium  or  before 
we  talk  very  much  about  doing  it,  we  had  better  be  sure  that  it  is 
all  due  to  total  abstinence  from  alcohol  or  tobacco,  and  we  had  bet- 
ter go  a  good  deal  further  in  our  investigations  in  our  attempt  to  make 
these  groups  homogeneous,  before  we  here  as  an  Association  or  as 
individuals  advocate  very  strongly  the  wide  separation  between  total 
abstainers  and  those  who  rarely  use. 

Dr.  Emery  (Manhattan  Life  Insurance  Company) — I  would  like 
to  make  a  suggestion  for  statistics  in  the  future,  and  that  is  to  find  out 
how  much  a  man  eats,  for  oftentimes  it  is  much  more  important.  A 
man  who  is  an  overeater  is  not  likely  to  live  as  long  as  some  excessive 
drinkers.  In  other  words,  a  man's  habits  of  eating,  and  whether  he 
performs  the  daily  functions  of  life  regularly  and  properly,  is  what  we 
should  know,  and  if  we  can  only  know  that,  I  think  we  would  do  a 
great  deal  more  than  we  do  now,  and  do  more  for  our  Companies.  It 
is  most  important.  The  man  who  is  known  as  a  club-man,  a  free  liver, 
is  generally  an  early  dier  (pp.  473-6,  Abstract  of  the  Proceedings  of 
the  Association  of  Life  Insurance  Medical  Directors  of  America,  from 
the  Seventeenth  to  and  including  the  Twenty-second  Annual  Meeting, 
New  York,    1912). 

Dr.  Dwight's  observations  clearly  stated  the  danger  of  taking 
too  seriously  the  figures  of  the  handful  of  English  life  com- 


6     DBA TH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS 

panics  which  maintain  separate  classes  for  abstaining  and  non- 
abstaining  policyholders,  and  succinctly  named  some  of  the 
many  all-important  factors  of  longevity  which  are  generally 
overlooked  in  considering  experience  with  these  classes.  Coming 
as  tney  do  from  so  professionally  conservative  an  observer  as 
the  Medical  Director  of  one  of  the  oldest  life  insurance  com- 
panies in  this  country,  they  are  deserving  of  most  thoughtful 
consideration  on  the  part  of  every  man  who  reads  them  and  is 
desirous  of  getting  as  nearly  as  possible  to  the  real  truth  of  the 
much-discussed  question  of  the  relative  death-rates  of  users 
and  non-users  of  alcohol.  For  these  reasons  I  have  reproduced 
them  in  their  entirety  as  reported  in  the  Proceedings  of  the  Asso- 
ciation, and  have  italicized  some  of  the  more  striking  pas- 
sages. 

A  CI^ASSIFICATION  RESTING  ON  BIASED  STATEMENTS  OE  APPLICANTS 

In  so  far  as  the  remarks  relate  to  the  general  question,  they 
would  seem  to  rest  on  a  bed-rock  basis,  and  to  be  entirely  with- 
out the  range  of  dissent  or  criticism.  But  in  so  far  as  they 
recite  the  supposed  experience  of  the  physician's  own  life  insur- 
ance company,  they  are  manifestly  open  to  the  criticism  which 
in  my  judgment  fairly  applies  to  the  returns  of  all  life  insurance 
companies  which  have  made  any  attempt  to  classify  their  policy- 
holders on  the  basis  of  their  individual  drinking  or  non-drinking 
habits.  On  just  what  grounds  does  that  classification  practically 
rest?  In  at  least  the  vast  majority  of  cases,  merely  on  the 
prejudiced  statement  made  by  the  policyholder  to  the  medical 
examiner  when  he  was  applying  for  his  life  insurance  in  the 
company  which  afterward  accepted  him.  To  be  sure,  of  late 
years,  and  especially  in  the  case  of  applications  for  large  policies, 
many,  if  not  most,  of  the  more  important  companies  send  in- 
spectors out  to  secure  supplemental  information  regarding  appli- 
cants for  policies — and  in  some  cases  may  have  investigations  of 
a  policyholder's  standing  and  habits  made  one,  two,  or  three 
years  after  the  policy  was  written.  But,  in  the  main,  practically 
all  of  the  so-called  statistics  of  life  insurance  experience  as  to 
allegedly  abstaining  and  non-abstaining  policyholders  solely  rest 
on  the  statements  made  by  the  policyholders  at  the  time  of 
applying  for  their  insurance. 


DBA  TH-RA  TBS  OF  ABSTAIN BRS  AND  NON-ABSTAINBRS    7 

Of  what  real  value  in  any  scientific  investigation  of  the 
mortality  rates  of  these  two  groups  of  policyholders  is  evidence 
so  gathered?  To  all  intents  and  purposes,  every  applicant  for 
life  insurance  knows  at  least  enough  of  the  attitude  of 
life  insurance  companies  to  feel  that  he  is  on  the  defensive,  so 
to  speak,  when  he  is  undergoing  his  medical  examination,  and 
to  be  cautious  in  his  answers  to  any  of  the  examiner's  questions 
as  to  his  habits  which  might  cause  his  rejection  by  the  company 
to  which  he  has  applied.  In  short,  the  applicant  is  necessarily 
a  biased  witness,  and  even  if  he  does  intend  to  tell  the  whole 
truth  about  his  habits,  previous  sicknesses,  etc.,  he  is  apt  to  take 
a  decidedly  optimistic  view  of  any  possible  defects  in  his  quali- 
fications as  a  first-class  life  insurance  risk. 

When  the  questions  as  to  drinking  habits  are  reached  in  the 
examination,  ninety-nine  per  cent,  of  the  applicants  who  admit 
drinking  at  all  are  reasonably  certain  to  classify  themselves  as 
"moderates,"  or  words  to  that  effect,  and  if  asked  for  details  as 
to  the  number  of  drinks  which  they  average  for  each  day  are 
absolutely  certain  not  to  oz^^rstate  their  daily  quantum.  In  the 
vast  majority  of  cases,  they  undoubtedly  wwd^rstate  the  daily 
average,  either  deliberately  or  unconsciously.  In  view  of  these 
well-known  facts,  how  much  importance  is  to  be  attached  to  the 
classification  by  Dr.  Dwight's  company,  or  any  other  company 
having  only  similar  evidence — or  lack  of  it — of  its  army  of 
policyholders  in  such  groups  as  "rarely  use,"  "temperate,"  and 
"moderate"  ?  Probably  no  two  men's  honest  notions  of  the  pre- 
cise meanings  of  these  terms  in  so  far  as  drinking  is  concerned 
would  exactly  tally;  daily  rations  of  alcohol  which  one  man 
might  honestly  regard  as  extremely  "temperate"  undoubtedly 
would  seem  decidedly  excessive  to  another  type  of  man,  and  so 
on  up  and  down  the  line. 

From  my  point  of  view  a  rating  on  any  such  basis  of  policy- 
holders as  to  their  individual  drinking  habits  would  be  prac- 
tically valueless,  even  though  they  were  to  be  polled  on  this 
question  once  a  year  during  the  entire  duration  of  their  policies. 
As  a  matter  of  fact,  they  are  actually  polled  but  once,  at  the 
time  their  policies  are  taken  out,  and  generally  in  their  early 
years,  and  of  course  their  habits  may  radically  change  for  bet- 
ter or  for  worse  before  their  deaths  are  entered  up  in  the  mor- 


8    DBA TH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS 

tality  of  the  "total  abstainer,"  "rarely  use,"  "temperate,"  or 
"moderate"  classes  to  which  they  were  assigned  many  years 
before,  and  in  which  they  have  continuously  since  been  rated. 
And  the  same  drawbacks  on  reliable  records  operate  in  the  case 
of  the  policyholder's  habits  respecting  the  use  of  tobacco. 

Furthermore,  a  moment's  consideration  of  the  figures  stated 
by  Dr.  Dwight  as  showing  his  Company's  supposed  experience 
with  these  several  classes  will  suffice  to  raise  the  most  serious 
question  as  their  probable  value.  For  instance,  the  total  abstain- 
ing class  are  credited  with  only  59  per  cent,  of  the  expected 
mortality  according  to  the  American  Experience  Table  of  Mor- 
tality, whereas,  the  "rarely  use"  class,  whom  Dr.  Dwight  de- 
fines as  "the  man  who  says  he  perhaps  twice  a  year  at  a 
dinner  drinks  two  glasses  of  champagne,"  is  charged  with  a  mor- 
tality of  71  per  cent,  of  the  expected,  or  an  increase  of  20.3 
per  cent,  over  the  mortality  of  the  class  which  does  not  drink 
at  all.  Would  even  the  most  enthusiastic  Prohibitionist  seri- 
ously think  of  contending  that  two  glasses  of  champagne  twice 
a  year  would  make  the  user  almost  one-quarter  again  as  bad 
a  life  insurance  risk  as  was  the  total  abstainer,  other  things 
being  even  ?  I  think  not.  To  go  a  step  farther  in  the  demonstra- 
tion of  the  absurdity  of  figures  so  calculated,  note  that  accord- 
ing to  Dr.  Dwight's  returns  the  mortality  of  even  the  "moderate" 
users  of  alcohol  accepted  by  his  Company  was  apparently  125 
per  cent,  of  the  expected  mortality  among  acceptable  life  insur- 
ance risks,  or,  in  other  words,  11 1.9  per  cent,  in  excess  of  the 
mortality  of  the  total  abstainers,  and  76.1  per  cent,  in  excess  of 
that  of  the  men  who  drank  only  two  glasses  of  champagne  twice 
a  year  at  dinners.  I  venture  to  believe  that  no  further  riddlmg 
of  these  supposed  returns  for  non-drinkers  and  moderate 
drinkers  is  necessary  to  show  that  they  are  not  entitled  to  serious 
consideration. 

The  grave  question  as  to  the  reliability  of  life  insurance 
returns  as  means  of  determining  the  relative  death-rates  of 
abstainers  and  non-abstainers  from  alcoholic  beverages  goes 
much  deeper  than  this.  The  classification  of  policyholders  as 
to  their  respective  drinking  habits,  when  based  on  their  own 
biased  statements  while  trying  to  qualify  as  acceptable  life 
insurance  risks — of  course,  as  a  rule,  many  years  before  their 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS    9 

deaths  figure  in  the  classification  of  the  companies'  mortality — at 
best  would  be  an  exceedingly  dubious  proceeding.  But  that  is 
by  no  means  the  weakest  link  in  the  chain  of  alleged  evidence 
as  to  the  relative  death-rates  of  drinkers  and  non-drinkers. 
What  conceivable  warrant  is  there  for  rating  in  one  group  all 
applicants  for  life  insurance  who  cannot  truthfully  and  cate- 
gorically assert  that  they  are  total  abstainers?  By  any  such 
extremely  loose  classification  the  man  who  actually  drinks  may- 
be two  or  three  glasses  of  wine  or  beer  in  the  course  of  an 
entire  year,  the  man  who  takes  a  cocktail  or  so  practically  every 
day  in  the  year,  and  the  man  who  regularly  takes  two  or  three 
drinks  of  whisky  or  other  distilled  liquor  each  day  are  all 
counted  in  the  single  group  of  non-abstainers.  Almost  countless 
other  sub-groupings  on  the  basis  of  what  they  drink,  how  much 
they  drink,  and  how  drinking  afifects  them  individually,  might 
doubtless  be  made  in  the  large  body  of  men  comprehensively 
branded  as  drinking  men,  or  non-abstainers,  by  the  few  life 
insurance  companies  which  undertake  so  to  classify  their  policy- 
holders. And  by  adding  up  all  the  deaths  in  this  group,  in  all 
probability  including  more  or  less  men  who  are  comparatively 
heavy  drinkers,  as  well  as  the  men  at  the  other  extreme  who 
practically  if  not  literally  are  total  abstainers,  an  alleged  death- 
rate  for  non-abstainers  is  obtained ! 

Can  any  such  process  be  regarded  as  rational,  let  alone  scien- 
tific ?  The  fact  that  precisely  that  sort  of  process  has  been  fol- 
lowed in  certain  quarters  for  many  years  proves  nothing,  for 
many  foolish  things  have  become  habitual.  Would  it  not  be 
equally  fair  to  classify  policyholders  by  their  answers  to  such 
absurd  questions  as,  for  instance,  "do  you  drink  cofifee,"  "do 
you  eat  Welsh  rarebits,"  "do  you  take  supper  after  going  to 
the  theatre?"  Some  of  the  men  who  had  to  plead  guilty  to 
these  implied  charges  might  confine  their  indulgence  in  coffee 
to  the  demi-tasse  after  the  banquet  which  they  semi-occasion- 
ally  attended,  might  not  care  for  Welsh  rarebits  and  not  eat 
more  than  one  a  year,  or  might  similarly  deviate  from  the 
straight  and  narrow  path  of  gastronomic  proprieties  by  going 
to  supper  after  the  theatre  once  or  twice  a  year,  whereas  others 
who  had  answered  "yes"  might  be  habitually  addicted  to  these 
hazards  of  indigestion  and  belated  sleep.     Would  any  sane  man 


10  DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS 

consider  it  fair  to  group  them  all  in  together,  and  attempt  to  fix 
a  conglomerate,  quasi-composite,  death-rate  for  the  cofifee- 
drinkers,  rarebit-eaters,  and  late-supper  contingent  on  this  basis  ? 
I  can  see  no  more  sense  in  pretending  to  work  out  the  death- 
rate  of  non-abstainers  on  a  similar  basis,  u  e.,  their  inability  if 
strictly  truthful  to  set  themselves  up  as  total  abstainers.  In 
brief,  the  non-abstainers  so  classified  are  about  as  heterogeneous 
a  body  of  men,  and  about  as  far  from  a  homogeneous  body  of 
men,  as  could  well  be  conceived.  And  surely  there  can  be  no 
difference  of  opinion  as  to  the  fundamental  necessity  of  at  least 
reasonably  homogeneous  groups  if  any  classification  of  the 
slightest  scientific  value  is  to  be  made.  The  real  issue  is  by 
no  means  the  accuracy  of  mortality  statistics  thus  compiled,  but 
is,  it  seems  to  me,  what  percentage  of  the  apparent  excess  of 
mortality  in  the  case  of  non-abstaining  as  compared  with  ab- 
staining policyholders  is  properly  chargeable  to  their  use  of 
alcohol,  what  percentage  to  their  other  habits,  what  percentage 
to  their  occupations,  and  so  on  and  so  on  almost  ad  infinitum f 
There  is  the  real  question,  as  I  see  it. 

MANY    FACTORS    CONTRIBUTE    TO    FIX    CI^ASS    MORTALITY 

To  illustrate  the  difficulties  of  credibly  and  scientifically 
grouping  the  death-rates  of  various  classes,  suppose  we  look  at 
the  thoroughly  reliable  mortality  statistics  of  England  and  Wales, 
admirably  classified  by  occupations  for  many  years  by  the  Regis- 
trar-General's office  in  its  decennial  supplements.  By  the  latest 
of  these  supplements  issued  in  1908  we  find  that  the  mortality 
of  clergymen,  priests  and  ministers  at  ages  35-45  in  England  and 
Wales  in  1900-1902  was  4.06  per  1,000,  whereas  that  of  general 
shopkeepers  at  the  same  ages  was  19.71  per  1,000,  or  nearly  five 
times  as  high.  Would  it  be  safe  to  assume  on  the  strength  of 
these  figures  that  the  shopkeeper's  occupation  was  nearly  five 
times  as  hazardous  as  that  of  the  clergy?  Dozens  of  similarly 
striking  contrasts  might  be  cited,  but  perhaps  no  further  evidence 
is  needed  to  make  it  clear  that  almost  countless  factors  con- 
tribute to  fix  the  mortality  rate  of  any  particular  group  of  lives, 
and  that  it  would  be  absurd  to  attempt  to  explain  the  difference 
between  the  mortality  rates  of  any  two  groups  by  citing  any 
single  factor  present  in  one  case  and  supposedly  absent  in  the 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS  H 

case  of  the  other  group.  That  is  precisely  what  is  done  by  the 
vast  majority  of  people  who  attempt  to  prove  by  the  compara- 
tively limited  experience  of  the  few  English  companies  with 
separate  classes  of  abstainers  and  non-abstainers  the  supposed 
difference  in  the  probable  longevity  of  people  who  do  and  people 
who  do  not  use  alcohol. 

In  the  discussion  before  the  Association  of  Medical  Direc- 
tors, as  shown  by  the  extracts  on  previous  pages  of  this  paper, 
Dr.  Emery  said :  "I  would  like  to  make  a  suggestion  for  sta- 
tistics in  the  future,  and  that  is  to  find  out  how  much  a  man 
eats,  for  oftentimes  it  is  much  more  important.  A  man  who 
is  an  over-eater  is  not  likely  to  live  as  long  as  some  excessive 
drinkers."  Have  any  of  the  discussions  of  the  apparent  death- 
rates  of  abstaining  and  non-abstaining  groups  in  English  life 
companies  maintaining  such  groups  of  policyholders  seriously 
taken  into  account  the  question  as  to  the  eating  habits  of  the 
two  groups  ?  Not  in  so  far  as  I  can  recollect.  Nevertheless, 
the  bad  physiological  effects  of  over-eating  in  the  way  of  undue 
strain  on  the  digestive  organs  and  the  clogging  of  the  whole 
system,  and  the  resultant  tendency  toward  arterio-sclerosis,  apo- 
plexy, and  other  degenerative  diseases  are  so  well  known  as  to 
call  for  no  enumeration  here.  I  have  had  many  eminent  physi- 
cians tell  me  they  had  no  question  that  more  people  were  killed 
by  over-eating  than  by  over-drinking.  But  practically  no  con- 
sideration seems  to  be  paid  to  this  important  factor  by  the  people 
who  triumphantly  cite  the  apparent  excess  of  the  death-rate  of 
non-abstainers  over  that  of  total  abstainers. 

While  it  is  scarcely  safe  to  trust  to  generalizations  as  to  the 
types  and  general  habits  of  men  who  do  and  men  who  do  not 
drink,  it  possibly  might  be  guardedly  said  that  as  a  rule  that 
section  of  the  modern  community  which  would  commonly  be  re- 
garded as  the  drinking  class  leads  more  active  and  strenuous 
lives,  keeps  later  hours,  and  in  both  their  work  and  play  is  sub- 
ject to  more  strain  than  are  those  who  never  indulge  in  any 
form  of  alcohol  as  a  means  of  relaxation.  Perhaps  it  would  not 
be  going  too  far  to  say  that,  all  things  considered,  the  total  ab- 
stainers and  the  non-abstainers  are  two  entirely  different  types 
of  men — although  of  course  there  are  many  notable  exceptions. 
Assuming  for  the  moment  that  this  hypothetical  type-differen- 


12  DBATH-RATBS  OP  ABSTAINERS  AND  NON-ABSTAINBRS 

tiation  is  correct,  might  it  not  be  expected  that  there  would  be 
more  or  less  difference  in  the  death-rates  of  the  two  types  of 
men,  even  though  alcohol  were  left  out  of  the  argument?  I 
think  ther6  can  be  little  question  on  that  score.  If  such  is  the 
case,  it  is  manifestly  a  case  of  unsound  reasoning  and  unscientific 
conclusions  to  set  up  the  difference  between  the  death-rates  of 
abstaining  and  non-abstaining  groups  of  life  insurance  policy- 
holders as  an  accurate  measure  of  the  effect  of  alcohol  on  human 
longevity.  That  is  constantly  being  done,  however,  in  the  im- 
passioned arguments  of  all  the  would-be  reformers  who  do  not 
themselves  approve  of  the  use  of  alcohol,  and  are  determined  to 
bring  the  rest  of  the  world  around  to  their  way  of  thinking. 

For  the  reasons  already  stated,  I  am  personally  unable  to 
regard  the  oft-quoted  figures  of  the  handful  of  small  English 
life  insurance  companies  which  have  long  maintained  separate 
classes  of  abstaining  and  non-abstaining  policyholders  as  evi- 
dence of  any  scientific  value  as  to  either  ( i )  the  respective  death- 
rates  of  the  drinking  and  non-drinking  classes  of  the  commu- 
nity in  general  or  (2)  an  accurate  measure  of  the  supposed  ex- 
cess of  the  death-rate  of  drinking  people  over  that  of  non- 
drinking  people.  If  the  reasons  for  this  distrust  previously 
cited  do  not  raise  a  similar  question  in  the  minds  of  all  un- 
biased readers,  suppose  the  figures  for  the  two  sections  of  the 
oldest  and  largest  of  all  the  English  life  insurance  companies 
in  the  field  of  discussion,  the  United  Kingdom  Provident  In- 
stitution, are  brought  into  the  argument  and  critically  analyzed. 
In  his  paper  presented  before  the  Association  of  Life  Insur- 
ance Medical  Directors  of  America,  on  the  subject  of  "The 
Use  of  Alcohol  and  the  Life  Insurance  Risk/'  Dr.  McMahon 
included  a  tabulation  of  the  "mortality  experience  under  ordi- 
nary whole  life  policies"  of  the  "temperance  section"  and  "gen- 
eral section"  of  the  above-named  English  company  for  the  forty- 
five  years,  1866-1910,  arranged  by  five-year  periods.  In  the 
figures  thus  presented  were  included  the  amounts  of  expected 
and  actual  claims  in  both  sections  for  each  period,  but  as  the 
amounts  of  claims  have  absolutely  no  bearing  on  the  number 
of  claims,  or  deaths,  and  as  the  averages  of  claims  in  the  two 
sections  for  the  forty-five  years  were  substantially  identical — 
respectively  $1,186  and  $1,167  ^or  the  Temperance  Section  and 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS  13 

the  General  Section — there  would  seem  to  be  no  reason  for 
clouding  the  issue  with  these  irrelevant  data.  Thus  edited,  the 
tabulation  of  the  mortality  experience  of  the  United  Kingdom 
Provident  Institution  presented  by  Dr.  McMahon  was  as 
follows : 


Temperance 
Section 

General 
Section 

Ratios  of  Actual 

Claims  to  Expected 

Claims 

Years 

Expected 
Claims 

Actual 
Claims 

Expected 
Claims 

Actual 
Claims 

Temperance 
Section 

General 
Section 

1866-70 
1871-75 
1876-80 
1881-85 
1886-90 
1891-95 
1 896-00 
1901-05 
1906-10 

549 
723 
933 
1,179 
1,472 
1,686 
1,900 
2,021 
2,291 

411 

511 
651 

835 
1,105 
1,203 
1,402 
1.456 
1,504 

1,008 
1,266 

1,485 
1,670 
1,846 
1,958 
2,058 
2,221 
2,282 

944 
1,330 
1,480 

1,530 
1,750 

1,953 
1,863 
1,961 
1,900 

74-86^ 
70.68 

69-77 
70.82 
68.95 
71-35 
73-79 
72.04 
65.21 

93-65^ 
102.60 

99-73 
91.61 

94-79 
99-74 
90.52 
88.29 
83.26 

Total, 
45  years 

12,754 

*8,988 

15,794 

14,7" 

70.47^ 

93-14% 

At  first  glance  these  figures  would  seem  to  show  a  general 
uniformity,  and  both  demonstrate  and  sharply  accentuate  the 
difference  between  the  death-rates  of  abstainers  and  non-ab- 
stainers by  an  experience  of  forty-five  years  with  a  total  of 
23,699  deaths,  or  an  average  of  about  527  deaths  a  year  or 
approximately  10  deaths  a  week.  A  study  of  the  figures  in 
detail,  however,  reveals  some  puzzling  discrepancies.  All  of 
the  persons  whose  deaths  are  included  in  the  above-tabulated 
mortality  presumably  had  passed  the  customary  medical  exami- 
nation and  had  been  accepted  as  good  life  insurance  risks.  If 
the  only  material  difference  between  the  two  classes  was  the  fact 
that  one  class  did  not,  and  the  other  class  did,  use  alcohol,  might 
it  not  naturally  be  expected  that  the  difference  between  the 
death-rates  of  the  two  classes  would  be  a  fairly  constant  differ- 


*  This  total  as  printed  in  the  Proceedings  of  the  Association  differs 
by  90  from  the  sum  of  the  figures  in  the  column,  indicating  a  probable 
typographical  error  in  the  column,  as  the  ratio  of  actual  to  expected 
claims,  70.47%,  tallies  with  the  total  given. 


14  DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS 


ence,  at  least  if  computed  by  five-year  periods  and  any  slight 
annual  discrepancies  thus  eliminated?    If  the  relative  mortality 
of  large  groups  of  policyholders  were  tabulated  for  five-year 
periods  by  either  occupations  or  localities,  a  substantially  con- 
stant difiference  would  be  expected  unless  changes  in  conditions 
or  other  abnormal  factors  had  been  interpolated  in  one  or  both 
groups.     The  "law  of  average"  would  so  demand,  and  proof 
of  the  fact  is  to  be  had  by  a  study  of  the  mortality  statistics  of 
England  or  any  other  country  which  has  tabulated  its  deaths  by 
occupations  or  other  sharply-defined  groupings  for  long  series 
of  years.     On  examination  of  the  mortality  experience  of  the 
two  sections  of  the  English  life  company  above  presented  it 
will  be  found  that  the  difference  between  the  death-rates  of  the 
abstainers  and  non-abstainers  was  by  no  means  constant,  except 
in  that  it  constantly  and  materially  varied,  as  is  shown  by  the 
following  tabulation  of  the  ratios  of  actual  to  expected  mortality 
in  the  two  sections  and  the  excess  and  percentage  of  excess  of 
the  General  Section's  ratios,  by  five-year  periods : 


Years 


Ratios  of  Actual  Claims 
TO  Expected  Claims 


General 
Section 


1866-70 

1871-75 
1876-80 

1881-85 
1886-90 
1891-05 
1896-00 
1901-05 
1906-10 


Averages 


9365^ 
102.60 

99  73 
91 .61 

94-79 
99-74 
90.52 
88.29 
83.26 


Temperance 
Section 


93  •H% 


74-86% 
70.68 

69.77 
70  82 
68.95 
71-35 
73-79 
72.04 
65.21 


Excess  and  Percentage  of  Excess  of 
General  Section's  Ratios  over 
Temperance  section's  Ratios  of 
Actual  to  Expected  Mortality 


Excess 


Percentage  of 
Excess 


70. 47% 


18.79 
31-92 
29.96 
20.79 
25.84 
28.39 
16.73 
16.25 
18.05 


25 
45 
42 
29 

37 

39 

22 
22 
27 


22.67 


32.2% 


This  tabulation  reveals  some  surprising  variations  in  the  five- 
year  differences  between  the  two  sections'  ratios  of  actual  to 
expected  mortality,  the  percentage  of  the  excess  of  the  General 
Section's  ratio  over  the  Temperance  Section's  ratio  of  actual  to 
expected  having  jumped  from  25.1  in  1866-70  to  45-2  per  cent. 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS  15 

in  1871-75,  or  nearly  doubled.  It  dropped  from  42.9  per  cent, 
in  1876-80  to  29.4  per  cent,  in  1881-85,  or  nearly  one-third,  and 
in  the  last  three  five-year  periods  was  approximately  only  one- 
half  as  large  as  in  1871-75,  and  continuously  much  lower  for  the 
fifteen  years  than  in  the  five-year  period  immediately  preceding 
that  epoch.  Why  this  pronounced  shifting  of  the  difference 
between  the  ratios  of  the  two  sections,  and  the  marked  decrease 
in  the  last  fifteen  years,  if  even  the  moderate  use  of  alcohol  to 
which  non-abstaining  accepted  life  insurance  risks  are  presum- 
ably restricted  ordains  a  decidedly  increased  death-rate  for  that 
class  as  compared  with  total  abstainers?  If  the  body  of  sur- 
viving non-abstaining  policyholders  were  to  increase  their  im- 
bibations  as  they  grew  older,  might  it  not  be  confidently  expected 
that  the  excess  of  their  death-rate  over  that  of  the  total  ab- 
stainers would  show  an  increase — especially  as  the  total  ab- 
stainers could  not  very  well  lower  their  own  death-rate  by  drink- 
ing less  than  nil?  As  the  above  tabulation  shows,  for  the  last 
fifteen  years  the  difference  between  the  death-rates  of  the  two 
sections  has  markedly  decreased,  instead  of  increased. 

NO  practicable;  measure:  for  a  general  death-rate  for  non- 
abstainers  FROM  ALCOHOL 

In  a  word,  this  last  tabulation  clouds  in  mystery  the  real 
significance  of  the  oft-cited  and  allegedly  conclusive  figures  of 
the  United  Kingdom  Provident  Institution's  mortality  experi- 
ence with  its  abstaining  and  non-abstaining  classes  of  policy- 
holders. I  can  conceive  of  but  one  of  two  explanations  of  the 
surprising  variations  in  the  difference  between  the  death-rates 
of  the  two  sections,  namely :  either  the  group  of  non-abstaining 
policyholders  in  the  General  Section  is  not  a  sufficiently  homo- 
geneous body  to  promise  a  constant  difference  between  its  death- 
rate  and  that  of  the  group  of  total  abstainers — which  in  at  least 
one  way  certainly  is  a  homogeneous  body — or  else  the  number 
of  lives  thus  grouped  is  too  small  to  warrant  safe  averages. 
Whichever  of  these  possible  explanations  is  accepted,  it  would 
seem  that  the  45-year  experience  of  the  United  Kingdom  Provi- 
dent with  groups  of  abstaining  and  non-abstaining  policy- 
holders by  no  means  affords  any  reliable  measure  of  the  alleged 


16  DBATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS 

decreased  longevity  of  non-abstainers.  And,  as  the  greater  pre- 
sumably includes  the  less  in  this  case  as  in  all  cases,  if  the  larger 
and  longer  oxperience  of  the  United  Kingdom  Provident  Insti- 
tution, of  London,  covering  forty-five  years,  does  not  afford  such 
a  measure,  of  what  value  are  the  materially  smaller  and  shorter 
experiences  of  the  Abstainers  and  General  Insurance  Company, 
of  Birmingham,  the  Sceptre  Life  Association,  Limited,  of  Lon- 
don, the  Scottish  Temperance  Life  Assurance  Company,  Lim- 
ited, of  Glasgow,  the  Manufacturers'  Life  Insurance  Company, 
of  Toronto,  and  the  Australasian  Temperance  and  General  Life 
Assurance  Society,  which  were  also  cited  by  Dr.  McMahon  in 
his  paper  before  the  Association  of  Life  Insurance  Medical 
Directors?  To  be  sure,  the  comparative  figures  for  all  of  these 
companies  show  a  considerably  higher  ratio  of  actual  to  ex- 
pected claims  in  their  General  Sections  than  in  their  Temper- 
ance Sections.  But,  as  no  two  of  the  comparisons  for  long 
stretches  of  years  even  approximately  concur  in  fixing  the  sup- 
posed margin  of  difference,  these  supplemental  data  only  tend 
to  confirm  the  doubt  as  to  the  real  value  of  any  life  insurance 
experience  on  these  lines.  In  so  far  as  life  insurance  experience 
in  the  United  States  is  concerned,  no  companies  of  any  import- 
ance now  maintain  separate  sections  of  abstaining  and  non- 
abstaining  policyholders,  or  ever  have  maintained  such  sections 
for  sufficient  time  to  afford  any  evidence  of  the  slightest  value. 
In  so  far  as  any  life  insurance  company's  mortality  experi- 
ence can  be  cited  by  the  spokesmen  for  the  temperance  cause 
as  alleged  mathematical  proof  and  measure  of  the  difference 
between  the  death-rates  of  the  two  types  of  men  loosely  classi- 
fied as  drinkers  and  non-drinkers,  the  comparatively  broad 
45-year  experience  of  the  United  Kingdom  Provident  Institu- 
tion undoubtedly  takes  precedence  of  all  other  supposed  evidence 
on  these  lines.  But,  looking  at  this  supposed  "evidence"  from  a 
purely  statistical  viewpoint,  for  the  reasons  already  enumerated 
I  cannot  regard  the  experience  in  question  as  of  any  value  as  a 
measure  of  the  presumptive  difference  between  the  death-rates 
of  the  two  groups  of  men  in  the  world  at  large.  At  most,  as  I 
see  it,  it  merely  corroborates  in  a  general  way  the  common  belief 
that  there  is  a  difference  between  the  death-rates  of  these  two 
types  of  men,  as  there  doubtless  is  between  any  two  large  groups 


DEATH-RATES  OP  ABSTAINERS  AND  NON-ABSTAINERS  17 

of  men  of  widely  different  habits,  amusements,  and  activities. 
But  the  margin  of  difference  between  the  recorded  death-rates 
of  the  abstaining  and  non-abstaining  groups  of  policyholders 
in  the  oldest  and  largest  of  the  life  companies  maintaining  such 
classes  so  sharply  varies,  even  when  carefully  computed  by  five- 
year  periods,  it  would  seem  impossible  to  believe  that  the  two 
groups  are  sufficiently  well-defined  to  be  fairly  comparable. 
If  the  good  and  bad  qualities  of  the  two  artificially-separated 
groups  of  life  insurance  risks,  or  the  physiological  credits  and 
debits,  so  to  speak,  were  reasonably  constant  factors,  might  it 
not  naturally  be  expected  that  the  difference  between  the  mor- 
tality of  the  two  groups — however  large  or  small  it  might  be — 
would  also  be  fairly  constant? 

That  the  difference  by  five-year  periods  is  anything  but  con- 
stant I  have  already  shown  by  the  tabulations  of  the  mortality 
experience  of  the  Temperance  Section  and  General  Section  of 
the  company  in  question.  To  the  eye  untrained  in  reading  and 
interpreting  figures,  however,  mere  tabulations  are  generally 
more  or  less  dumb  mysteries,  and  by  way  of  simplifying  in 
graphic  form  which  any  man  can  instantly  read  the  widely 
fluctuating  differences  between  the  mortality  experiences  of 
the  two  groups  in  question,  I  have  translated  the  tabulations  in 
question  into  the  chart  which  accompanies  this  paper.  In  this 
plainspoken  chart  the  excess  of  the  five-year  ratios  of  actual 
to  expected  mortality  in  the  General  Section  over  the  corre- 
sponding ratios  of  the  Temperance  Section  is  traced  by  the 
decidedly-wavy  plotted  line  which  records  the  ever-varying  per- 
centage of  that  excess,  and  the  heavy  plotted  horizontal  line 
showing  the  average  excess  for  forty-five  years  by  its  marked 
contrast  with  the  other,  up-hill-and-down-dale,  plotted  line 
sharply  emphasizes  the  fact  that  the  excess  was  far  from  being 
a  fixed  quantity.  It  would  seem  that  this  chart  could  scarcely 
fail  to  raise  a  serious  question  as  to  the  real  value  of  the  United 
Kingdom  Provident  mortality  comparisons  in  the  mind  of  any 
impartial  student  of  the  alcoholic  problem  who  may  happen  to 
glance  at  it. 

But  I  gravely  doubt  if  the  graphic  showings  of  the  chart 
will  have  any  significance  in  the  eyes  of  the  over-zealous  type 
of  Prohibition  advocates  who  apparently  have  no  patience  with 


18  DBATH-RATES  OF  ABSTAINBRS  AND  NON-ABSTAINBRS 


t866-  1871-  1876-  1881-  I 
1870   1875   1880  1885   I 


Average, 
1866-1910 


45^ 


Ao% 


3S% 


Average, 
1866-1910 


30^ 


25% 


20% 


A    GRAPHIC    RECORD   OF   THE    FIVE-YEAR   FLUCTUATIONS   IN   THE   DIFFER- 
ENCE   BETWEEN   THE    RATIOS   OF   ACTUAL   TO    EXPECTED    DEATHS 
IN   THE   GENERAL   AND   TEMPERANCE   SECTIONS   OF   THE 
UNITED   KINGDOM   PROVIDENT   INSTITUTION 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS  19 

any  evidence  which  does  not  tend  to  support  their  contentions. 
So  deeply  immersed  are  they  in  the  movement  in  which  they 
have  enHsted  that  they  are  scarcely  qualified  for  jury-duty  m 
cases  in  which  any  phase  of  the  alcoholic  problem  is  involved. 
In  his  notable  address  before  the  Insurance  and  Actuarial  So- 
ciety of  Glasgow,  on  February  i,  1909,  under  the  title  of  "Some 
Observations  on  the  Comparative  Death-Rates  of  Abstainers 
and  Non-Abstainers  in  Life  Assurance  Companies,"  Dr.  Eben- 
ezer  Duncan,  F.  F.  P.  S.  G.,  J.  P.,  remarked:  "I  have  found 
some  strong  teetotallers  genial,  generous,  and  lovable  men,  but 
with  characteristic  failings,  and  one  of  the  worst  of  them  is  a 
habit  of  exaggeration  and  intemperance  in  their  statements  about 
moderate  and  temperate  indulgence  in  beverages  containing  a 
percentage  of  alcohol  and  about  the  evils,  often  imaginary,  of 
such  moderate  indulgence.  I  would  venture  to  suggest  to  them 
that  they  should  give  up  using  the  word  Temperance  in  con- 
nection with  societies  which  demand,  in  conformity  with  their 
fundamental  principles,  a  pledge  for  total  abstinence  from  every 
member,  and  which  also  demand  that  the  State  shall  carry  out 
a  policy  of  total  abolition  of  the  sale  of  alcoholic  beverages. 
The  battle  of  the  true  temperance  party  can  only  be  won  by 
rational  means  directed  towards  the  uplifting  of  the  whole  moral 
and  social  life  of  the  people — by  evolutionary  and  not  by  revo- 
lutionary measures." 

SCHOOL-CHII^DREN   CALLED  ON   TO   SOIvVE:   A   WORLD   PROBLEM  ! 

An  excellent  illustration  of  this  intemperate  policy  of  tem- 
perance advocates  to  which  Dr.  Duncan  alluded  is  furnished  by 
one  of  the  latest  of  the  many  Temperance  leaflets  which  have 
come  my  way  since  the  publication  of  my  book  on  "The  Mor- 
tality of  Alcohol."  The  32-page  booklet  in  question  bears  the 
title  of  "The  Effect  of  Alcoholic  Drinks  upon  the  Human  Mind 
and  Body,"  was  prepared  by  the  Scientific  Temperance  Feder- 
ation, of  Boston,  was  published  by  the  Anti-Saloon  League  of 
Maryland,  and,  as  its  title-page  announces,  was  intended  "for 
the  use  of  the  Public  School  Pupils  of  Baltimore  in  competing 
for  the  400  prizes  offered  for  the  best  essays  on  the  above  sub- 
ject." Under  the  heading  of  "The  Prize  Offer"  the  details  of 
the  proposed  competition  are  recited  at  length,  and  in  part  read 
as  follows : 


20  DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS 

"Three  gentlemen  especially  interested  in  the  scientific  and 
health  aspect  of  the  temperance  question  offered  $i,ooo  each 
through  the  Anti-Saloon  League  of  Maryland  for  a  fund  for 
prizes  for  the  best  essays  written  by  pupils  in  the  Baltimore  Pub- 
lic Schools  on  the  subject :  'The  Effect  of  Alcoholic  Drinks  upon 
the  Human  Mind  and  Body.'  The  offer  is  as  follows  :  The  Anti- 
Saloon  League  of  Maryland  hereby  offers  a  cash  prize  of  $3.00 
for  the  best  essay  on  the  above  subject  written  by  a  pupil  in 
each  of  the  five  highest  grades  in  each  of  the  approximately  100 
elementary  schools  of  Baltimore  City.  The  League  further  offers 
four  district  prizes  of  $10  each  for  each  of  these  five  highest 
grades,  and  a  city-wide  prize  of  $50  for  each  of  the  five  highest 
grades,  making  five  $50  prizes,  twenty  $10  prizes  and  from  350 
to  360  $3.00  prizes  for  the  elementary  schools.  The  League 
also  offers  a  prize  of  $10  for  the  best  essay  written  by  a  pupil 
in  each  of  the  four  regular  annual  classes  in  each  of  the  five 
secondary  schools,  and  a  city-wide  prize  of  $50  for  the  best 
essay  from  each  of  the  four  yearly  classes  in  the  secondary 
school  system,  making  twenty  prizes  of  $10  each  and  four 
prizes  of  $50  each  for  the  secondary  schools." 

The  pamphlet  further  states  that  agreement  was  made  by 
the  League  with  the  Scientific  Temperance  Federation,  of  Bos- 
ton, to  prepare  and  furnish  "a  32-page  pamphlet  devoted  entirely 
to  the  scientific  and  health  aspect  of  the  question  and  containing 
no  mention  of  the  Anti-Saloon  League  or  any  other  temperance 
organization,  of  local  option  or  Prohibition,  of  the  saloon  as  an 
institution  or  any  other  political  or  controversial  phase  of  the 
subject,"  copies  of  this  pamphlet  to  be  furnished  free  to  the 
30,000  pupils  in  the  grades  open  to  the  prize  contest.  The 
pamphlet  so  prepared,  it  is  announced,  was  approved  by  a  sub- 
committee of  the  Board  of  School  Commissioners  of  Baltimore, 
but  by  a  vote  of  5  to  4  the  Board  refused  to  accept  it,  and  "the 
Anti-Saloon  League,  therefore,  because  of  the  great  public  in- 
terest manifested,  has  determined  to  place  a  copy  of  this  pamph- 
let in  every  one  of  the  more  than  100,000  homes  in  Baltimore 
City." 

The  utter  lack  of  scientific  promise  in  this  offer  of  $3,000 
for  a  prize-competition  of  30,000  school  children  with  essays  on 
"The  Effect  of  Alcoholic  Drinks  upon  the  Human  Mind  and 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS  21 

Body"  is  so  self-evident  that  any  analysis  of  its  elements  of 
absurdity  would  be  needless.  There  are  comparatively  few  men 
in  the  world  who  are  competent  to  handle  in  illuminative  and 
judicial  fashion  so  profoundly  complicated  a  subject;  and  of 
course  for  children  scarcely  in  their  teens  the  subject  prescribed 
for  the  essays  would  be  a  very  bottomless  abyss.  All  competent 
educators  are  agreed  on  not  only  the  uselessness  but  undesir- 
ability  of  calling  on  children  to  write  on  subjects  obviously  with- 
out their  mental  reach,  and  the  propriety  of  holding  before  the 
eyes  of  public  school  children  the  glittering  inducement  of  con- 
siderable cash  prizes  for  concentration  of  their  youthful  energies 
on  one  detail  of  physiology,  or  any  other  one  phase  of  their 
school  work,  would  seem  extremely  dubious.  These,  however, 
are  matters  within  the  educators'  domain,  upon  which  my  judg- 
ment is  merely  that  of  a  layman,  but  I  venture  to  believe  my 
study  of  the  subject  has  qualified  me  to  some  extent  to  pass  upon 
certain  phases  of  "the  effect  of  alcoholic  drinks  upon  the  human 
mind  and  body."  And  I  must  emphatically  dissent  from  my 
Prohibitionist  friends  as  to  the  scientific  value  of  many  of  the 
alleged  facts  and  figures  cited  by  them  in  their  anti-alcoholic 
literature  in  general,  and  in  the  pamphlet  intended  for  the 
school  children  of  Baltimore  in  particular. 

Practically  all  of  the  Prohibitionist  literature  which  I  have 
examined  strongly  savors  of  assumptions  and  exaggeration  from 
the  first  page  to  the  last,  mere  estimates  and  personal  opinions  as 
to  the  effects  of  alcohol  almost  invariably  being  brought  forward 
in  the  disguise  of  demonstrated  facts.  One  of  the  pre-requisites 
for  scientific  research  work  is  a  long-continued  series  of  experi- 
ments with  each  tentative  formula,  and  no  investigator  with  the 
slightest  respect  for  his  reputation  would  be  prepared  to  an- 
nounce his  conclusions  as  established  facts  until  he  had  gone 
through  that  sine  qua  non  of  scientific  processes.  As  to  the  bad 
effects  upon  the  human  mind  and  body  of  excessive  use  of 
alcohol,  coffee,  tobacco,  or  practically  any  beverage,  food,  or 
other  indulgence,  of  course  there  can  be  no  question.  On  this 
point  non-abstainers  from  alcohol  will  fully  agree  with  the  advo- 
cates of  total  abstinence  from  alcohol.  But  a  very  large  per- 
centage of  the  population  of  the  civilized  world  vigorously  dis- 
sents  from  the   Prohibition  contention  that  all  indulgence  in 


22  DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS 

alcohol,  however  moderate,  necessarily  produces  bad  effects  on 
all  men,  whatever  their  ages,  habits,  and  manner  of  living,  and 
declines  to  accept  as  proof  of  that  alleged  fact  the  personal 
opinions  and  hypothetical  estimates  of  scientific  or  unscientific 
investigators  who  are  strongly  prejudiced  against  the  use  of 
alcohol.  Up  to  date  the  scientific  investigation  of  the  effects  of 
moderate  use  of  alcohol  is  in  its  very  infancy,  in  so  far  as  the 
deduction  of  proven  and  undebatable  conclusions  is  concerned, 
and  as  to  many  phases  of  the  complex  subject  there  are  the 
widest  variations  of  more  or  less  expert  opinion.  Nevertheless, 
Prohibition  literature  almost  invariably  sets  up  as  positive  facts 
of  universal  application  the  assertions  and  estimates  of  its 
sympathizers  and  spokesmen,  and  the  pamphlet  on  "The  Effect 
of  Alcoholic  Drinks  upon  the  Human  Mind  and  Body,"  which 
was  prepared  for  the  use  of  the  public  school  children  of  Balti- 
more in  their  proposed  prize-essay  competition  on  that  subject 
is  no  exception. 

As  to  the  fairness  or  unfairness,  accuracy  or  inaccuracy,  of 
that  section  of  the  pamphlet  which  purports  to  deal  with  the 
effect  of  alcohol  upon  the  human  mind,  I  have  no  opinion  to 
express.  That  phase  of  the  subject  is  one  on  which  only 
specialists  in  physiology  and  psychology  can  intelligently  pass. 
But  with  the  matter  presented  under  the  sub-title  of  "Drink's 
Cost  in  Lives"  I  am  very  much  interested,  especially  as  at  the 
very  outset  of  that  chapter  the  somewhat  startling  assertion  of 
"one  death  every  eight  minutes  due  to  drink"  is  made  to  rest 
upon  the  figures  presented  in  my  book  on  "The  Mortality  of 
Alcohol,"  and  the  specific  statement  is  made  that  "alcohol  carries 
off  1,662  adults  every  nine  days  all  the  year  round  in  the  United 
States,  65,897  a  year,  according  to  the  estimate  of  Edward 
Bunnell  Phelps  based  on  the  estimates  of  medical  directors  of 
three  of  the  large  American  life  insurance  companies"  (p.  22). 

I  trust  I  may  not  seem  to  place  myself  in  an  ungracious  posi- 
tion if  I  flatly  deny  my  responsibility  for  this  statement  charged 
to  me,  and  herewith  cite  from  my  book  literal  proof  that  I  made 
no  such  estimate.  In  the  final  tabulation  on  page  64  of  my  book 
I  did  present  the  figure  65,897  as  the  possible  number  of  "deaths 
in  which  alcohol  may  have  figured  as  a  causative  or  contributory 
factor,"  but  my  "Conclusions"  began  on  page  73  with  this  para- 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS  23 

graph  which,  it  seems  to  me,  is  incapable  of  the  slightest  misun- 
derstanding as  to  its  real  meaning: 

"In  default  of  proof  positive  to  the  contrary,  it  would  there- 
fore seem  entirely  safe  to  assume  that  the  total  annual  mortality 
of  Continental  United  States  in  which  alcohol  directly,  indi- 
rectly, or  even  remotely,  figures  as  a  causative  or  contributory 
factor  at  last  reports  did  not  exceed  the  66,000  deaths  approxi- 
mately suggested  by  this  investigation.  It  should  be  clearly 
understood  that  this  figure  by  no  means  signifies  that  alcohol 
was  the  direct  cause  of  66,000  deaths,  the  number  in  question 
presumably  including  all  of  the  deaths  in  which  alcohol  played 
any  appreciable  contributory  part.  Consequently  the  number  of 
deaths  thus  computed  is  not  properly  comparable  with  the  num- 
ber of  deaths  accredited  to  any  particular  cause  in  the  annual 
Mortality  Statistics  of  the  Registration  Area,  as  in  every  case 
those  figures  deal  with  deaths  immediately  due  to  the  cause 
named." 

I  do  not  see  how  any  person,  Prohibitionist  or  anti-Prohibi- 
tionist, could  possibly  mistake  this  statement  for  an  estimate  on 
my  part  that  "alcohol  carries  off  1,662  adults  every  nine  days 
all  the  year  round  in  the  United  States,  65,897  a  year."  In  the 
case  of  any  death,  there  may  be  two,  three  or  half  a  dozen  con- 
tributory causes,  and  surely  no  one  of  these  more  or  less  remote 
contributory  causes — alcohol  or  anything  else — could  properly 
be  charged  as  the  cause  which  "carries  off"  that  particular  de- 
ceased individual,  any  more  than  old  age  could  rightfully  be 
cited  as  the  cause  of  death  in  all  cases  of  death  at  advanced 
ages.  Apparently  the  compilers  of  the  Baltimore  pamphlet 
allowed  their  zeal  to  lead  them  to  a  serious  misinterpretation  of 
the  figures  presented  in  my  book. 

INACCURATE  DATA  PROFFERED  AS  GUIDE:  FOR  YOUTHFUL  ESSAYISTS 

That  mistake,  to  apply  the  most  charitable  of  constructions 
to  it,  is  but  one  of  various  mistakes,  or  mis-statements  of  fact, 
which  I  have  noted  in  the  pamphlet  in  question,  among  them,  for 
instance,  being  the  following  assertion  of  alleged  facts  on 
page  22 :  "In  8  years,  1900- 1908,  smallpox  carried  off  2,214  men 
25-65  years  of  age  in  the  registration  area  of  the  United  States. 
Typhoid  carried  of  22,211  men.     But  alcoholism,   for  which 


24  DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS 

alcohol  was  wholly  responsible — and  the  75  per  cent,  of  liver 
cirrhosis  which  may  be  charged  to  alcohol,  carried  off  33,139 
men ;  10,928  more  thgn  typhoid,  and  more  than  fifteen  times  as 
many  as  smallpox." 

The  references  to  "8  years,  1900-1908"  and  "men  25-65 
years  of  age"  are  somewhat  ambiguous  (i)  as  to  which  of  the 
terminal  years  of  the  period  is  included  in  the  "8  years,"  and 
(2)  as  to  the  grouping  of  deaths  between  ages  25-65,  as  the  mor- 
tality statistics  for  the  registration  area  do  not  furnish  figures 
for  mortality  by  individual  years  after  age  4,  and  include  the 
deaths  at  age  65  in  those  for  the  age-group  65-69.  Presumably, 
however,  the  8-year  period  considered  was  that  of  1900-1907, 
inclusive,  and  the  age-period,  25-64,  inclusive,  and  the  figures 
for  those  years  and  that  age-period  presented  in  the  Mortality 
Statistics  of  the  Census  Office  for  the  years  1900- 1907  do  not 
tally  with  the  pamphlet's  figures,  as  this  tabulation  of  the  actual 
returns  demonstrates : 

Male  Deaths  at  Ages  25-64,  inclusive,  in  the  Registration 

Area  of  the  United  States  in  the  Years  1900-1907, 

inclusive,  as  Recorded  in  the  Census  Office 

Mortality  Statistics  for  Those  Years 


Years 

Typhoid 
Fever 

Smallpox 

Alcoholism 

Cirrhosis  of 
Liver 

1900 
1 901 
1902 
1903 
1904 
1905 
1906 
1907 

3.427 
3.293 
3.531 
3.527 
3.394 

2,993 
4,162 

4,167 

205 

332 
727 
485 
248 
125 
42 
24 

1,506 

1,426 

1,497 
1,704 

1-497 
1,640 
2,150 

2,474 

1,918 

2,117 
2,198 
2,351 
2,515 
2,492 
3,035 
3.321 

Totals  for 
8-years,  1900-07 

28,494 

2,188 

13,894 

19.947 

As  this  tabulation  shows,  "typhoid  carried  off  28,494  men 
of  ages  25-64,  inclusive,  in  1900-1907,  inclusive,  instead  of  the 
22,211  stated  in  the  Baltimore  pamphlet,  smallpox  carried  off 
2,188  men,  instead  of  2,214,  and  if  75  per  cent,  of  the  19,947 
male  deaths  from  cirrhosis  of  the  liver  at  ages  25-64,  inclusive. 


DBATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS  25 

or  14,960,  were  to  be  added  to  the  13,894  deaths  charged  to  alco- 
holism, the  total  from  both  causes  would  be  28,854,  instead  of 
33,139  as  alleged  in  the  pamphlet.  In  other  words,  the  actual 
excess  over  the  deaths  from  typhoid,  of  male  deaths  so  com- 
puted from  the  returns  for  alcoholism  and  cirrhosis  of  the  liver 
at  ages  25-64,  inclusive,  was  360,  and  not  10,928  as  alleged,  and 
there  were  only  thirteen,  instead  of  fifteen,  times  as  many  male 
deaths  from  these  causes  as  from  smallpox  at  these  ages.  These 
mis-statements,  or  inaccuracies,  in  the  pamphlet's  supposedly 
official  figures  are  of  not  great  consequence,  however,  except  as 
tending  to  indicate  the  general  unreliability  of  specific  Prohibi- 
tion contentions,  as  the  very  basis  of  any  such  comparisons  is  so 
manifestly  unfair  and  misleading. 

On  the  one  side,  that  of  deaths  due  to  typhoid  and  smallpox, 
only  the  deaths  primarily  due  to  these  diseases  and  so  directly 
charged  are  included  in  the  comparison ;  on  the  other  side,  not 
only  the  deaths  directly  due  to  alcoholism  according  to  the  official 
death  returns  but  the  exceedingly  liberal  addition  of  "the  75  per 
cent,  of  liver  cirrhosis  which  may  be  charged  to  alcohol"  are 
included.  What  is  the  authority  for  this  assumption  that  75  per 
cent,  of  all  male  deaths  from  cirrhosis  between  ages  25-64,  in- 
clusive, may  properly  be  charged  to  alcohol  ?  None  is  given,  and 
there  is  no  such  authority  in  so  far  as  I  am  aware.  In  the  esti- 
mates of  male  mortality  at  ages  20-74,  inclusive,  in  which  alcohol 
might  possibly  figure  as  a  causative  or  contributory  factor  fur- 
nished for  my  book  by  the  medical  directors  of  three  insurance 
companies,  one  fixed  the  possible  responsibility  of  alcohol  for 
deaths  apparently  due  to  cirrhosis  at  30  per  cent,  and  another 
one  at  90  per  cent.  This  wide  margin  of  difference  in  expert 
estimates  proves  how  far  apart  are  trained  medical  observers  on 
this  phase  of  the  alcoholic  subject,  and  it  was  decidedly  pre- 
sumptuous for  the  Baltimore  pamphlet  to  announce,  without 
citing  any  authority,  that  "75  per  cent,  of  liver  cirrhosis  may  be 
charged  to  alcohol."  But,  as  I  have  said,  these  details  of  inac- 
curacy are  of  only  minor  consequence,  the  attempted  compari- 
son of  entirely  dissimilar  items  voiding  the  apparent  showings 
of  any  value. 

The  alleged  figures  for  adult  male  deaths  due  to  typhoid, 
smallpox,  and  alcoholism  and  cirrhosis  being  incorrect,  of  course 


26  DEATH-RATBS  OP  ABSTAINERS  AND  NON-ABSTAINERS 

the  diagram  in  which  the  "comparative  mortaHty  from  typhoid 
fever,  small-pox  and  alcoholism"  is  supposedly  shown,  in  highly 
worked-up  fashion,  is  similarly  misleading.  And,  for  the 
reasons  discussed  at  length  on  the  early  pages  of  this  paper,  the 
diagram  purporting  to  picture  "moderate  drinking  and  the  death 
rate  facts  from  the  life  insurance  companies,"  on  the  strength 
of  the  United  Kingdom  and  Sceptre  Life  companies'  mortality 
figures  for  total  abstainers  and  non-abstainers,  seems  to  me  to  be 
distinctly  misleading.  The  last-named  diagram  does  at  least 
have  the  justification  of  resting  on  presumably  correctly-quoted 
figures  of  the  little  British  life  insurance  companies  in  question 
for  their  respective  "temperance  section"  and  "general  section" 
groups  of  policyholders,  but  until  much  broader  and  much  more 
carefully  classified  experience  is  forthcoming,  no  diagrams  laid 
out  on  these  lines  can  be  accepted  as  correctly  presenting  the 
relative  death-rates  of  moderate  drinkers  and  total  abstainers. 
Undoubtedly  some  of  the  men  who  were  moderate  drinkers 
when  they  took  out  their  policies  in  the  British  companies  in 
question  become  immoderate  drinkers  before  they  die,  and 
some  of  the  men  who  were  not  total  abstainers  when  they  in- 
sured practically  if  not  actually  become  non-drinkers  in  later 
life.  How,  then,  can  diagrams  worked  out  on  such  uncertain 
and  constantly-changing  experience  be  supposed  to  record  accu- 
rately the  death-rate  of  moderate  drinkers,  when  some  of  the 
men  so  classified  probably  drink  to  excess  and  others  so  classi- 
fied practically  do  not  drink  at  all? 

INACCURACY  A  COMMON  WEAKNESS  OF  PROHIBITION  LITERATURE 

These,  and  many  other,  veins  of  inaccurate  showings  and 
conclusions  seem  to  underlie  the  entire  mass  of  Prohibition 
literature,  and  are  by  no  means  wanting  in  many  of  the  public 
school  text-books  on  physiology,  in  the  sections  devoted  to  the 
effects  of  alcohol  and  narcotics.  According  to  the  World 
Almanac,  "all  the  States  in  the  Republic  have  laws  requiring 
the  study  of  scientific  temperance  in  the  public  schools  (what- 
ever that  may  mean),  and  all  these  laws  were  secured  by  the 
W.  C.  T.  U."  (the  Women's  Christian  Temperance  Union). 
These  laws  emanating  from  a  single  source,  it  is  but  natural  that 
they  should  be  substantially  alike  in  their  respective  require- 


DEATH-RATBS  OF  ABSTAINERS  AND  NON-ABSTAINBRS  27 

ments  and  phraseology.  Probably  for  similar  reasons,  there  is 
considerable  uniformity  in  the  treatment  of  alcohol  and  tobacco 
in  the  physiological  text-books  used  in  the  public  schools  in  com- 
pliance with  these  laws,  and  it  is  extremely  probable  that  any 
text-book  which  did  not  meet  with  W.  C.  T.  U.  approval  on 
these  lines  would  have  a  rocky  road  to  travel  in  finding  its  way 
into  American  public  schools.  The  fact  that  a  considerable 
majority  of  the  male  parents  of  the  children  in  the  public  schools 
of  this  country  themselves  probably  use  either  alcohol  or  tobacco 
to  some  extent  clearly  indicates  that  the  introduction  of  the  anti- 
alcohol  and  anti-tobacco  instruction  in  the  public  school  curricu- 
lum was  not  made  in  response  to  a  general  public  demand,  but 
largely  if  not  entirely  through  the  determined  efforts  of  the 
W.  C.  T.  U. 

The  public  at  large,  and  certainly  all  intelligent  men  irre- 
spective of  their  Prohibition  or  anti-Prohibition  leanings,  un- 
doubtedly would  approve  of  rational  temperance  teaching  for 
their  children,  and  the  advisability  of  such  teaching  probably 
would  be  approved  by  a  substantially  unanimous  vote  if  put  to 
the  test  of  the  ballot.  But  there  are  many  careful  observers,  and 
by  no  means  necessarily  drinking  men,  who  firmly  believe  that 
the  W.  C.  T.  U.  movement  has  decidedly  overshot  its  mark  and 
worked  real  injury,  instead  of  good,  to  the  general  welfare,  not 
only,  for  instance,  by  the  misguided  abolition  of  "the  canteen" 
at  U.  S.  Army  posts,  but  in  its  arbitrary  and  unreasoning  inter- 
ference with  the  public  schools  in  the  way  of  insisting  on  the 
adoption  of  biased  and  unscientific  text-books,  forcing  the  study 
by  children  of  subjects  which  they  cannot  grasp,  and  insisting 
that  the  teachers  of  these  children,  whatever  their  own  views 
may  be,  shall  accept  and  inculcate  in  their  pupils  as  absolute 
truths  mere  opinions  on  the  subject  of  alcohol  and  tobacco  which 
have  been  stamped  with  W.  C.  T.  U.  approval. 

Until  I  became  interested  in  the  subject,  and  took  occasion 
to  run  over  the  laws  of  the  various  States  dealing  with  these 
forms  of  physiological  teaching  in  the  public  schools,  I  had  no 
idea  of  the  extraordinary  requirements  of  some  of  these  statutes, 
or,  for  instance,  that  at  least  20  States  require  that  their  teachers 
shall  pass  examinations  as  to  their  proficiency  in  physiology  and 
hygiene.     As  a  rule,  properly  enough,  the  laws  demand  thai 


28  DEATH-RATBS  OF  ABSTAINERS  AND  NON-ABSTAINERS 

physiology  and  hygiene  shall  be  taught  in  all  public  schools,  or 
in  all  schools  in  part  or  in  whole  supported  by  public  money. 
Some  States  exempt  certain  schools,  or  grades,  from  these  laws, 
apparently  on  the  sensible  tileory  that  the  youngest  of  school 
children  could  scarcely  digest  instruction  in  physiology  and 
hygiene,  but  New  York,  New  Jersey,  and  several  less  important 
States  specifically  require  oral  teaching  on  these  lines  for  chil- 
dren as  yet  unable  to  read!  The  use  of  adequate  text-books 
on  these  subjects  is  generally  required  or  implied  in  the  statutes, 
and  State  or  local  boards  or  superintendents  commonly  have  the 
say  as  to  which  text-books  shall  be  used,  Indiana  alone  exempt- 
ing its  teachers  from  using  text-books  unless  they  so  elect. 

In  some  States,  principals  or  teachers  must  file  sworn  state- 
ments that  the  laws  on  these  lines  have  been  complied  with,  and 
New  Hampshire  has  a  statute  requiring  the  superintendent  of 
schools  to  investigate  the  teachers'  instruction  in  physiology, 
with  special  reference  to  that  regarding  alcoholic  stimulants.  In 
Pennsylvania,  New  Jersey,  Oregon,  South  Dakota  and  Wyo- 
ming failure  to  comply  with  the  law  is  made  sufficient  cause  for 
withholding  school  appropriations ;  New  York,  Idaho  and  North 
Dakota  provide  that  a  teacher's  certificate  may  be  revoked  for 
failure  or  refusal  to  teach  the  prescribed  course  in  physiology; 
and  in  Ohio  the  teacher  so  offending  may  be  fined  $25.  Pennsyl- 
vania even  goes  so  far  as  to  provide  that  no  person  in  the  habit 
of  using  any  intoxicating  drink  as  a  beverage  shall  be  eligible  to 
teach  physiology,  and  in  Iowa  the  advancement  of  scholars  is 
made  dependent  on  their  proficiency  in  physiology  and  hygiene. 

The  pendulum  having  swung  so  extremely  far  in  this  direc- 
tion in  the  earlier  days  of  the  W.  C.  T.  U.  movement  has  latterly 
tended  to  swing  in  the  other  direction,  at  least  in  certain  States. 
In  many  States  the  subjects  of  physiology  and  hygiene  are  not 
now  taught  in  all  public  schools,  and  other  States  have  adopted 
really  scientific  physiological  text-books  from  which  the  un- 
scientific and  exaggerated  statements  of  some  of  the  earlier 
text-books  have  been  eliminated,  and  temperate  statements  as 
to  stimulants  and  narcotics  substituted.  Connecticut  set  a  new 
high-water  mark  among  States  by  prescribing  an  official  physio- 
logical text-book  of  its  own  construction,  but  it  was  not  radical 
enough  for  the  Prohibitionists,  and  they  had  the  law  of  their 


DEATH-RATES  OF  ABSTAINERS  AND  NON-ABSTAINERS  29 

own  creation  repealed.  If  I  am  correctly  informed,  however,  the 
nominally-discarded  official  text-book  is  still  being  extensively 
used  in  the  Nutmeg  State. 

In  one  of  the  very  latest — and  in  many  respects,  the  very 
best — of  the  text-books  of  Human  Physiology,  a  copy  of  which 
I  happen  to  have,  more  than  twenty  of  the  362  pages,  and  many 
diagrams,  are  given  up  to  the  subject  of  alcohol  and  tobacco, 
and  conspicuous  in  the  chapter  on  "The  Effects  of  Alcohol  on 
the  Human  Body"  is  the  citation  of  the  mortality  experience  of 
the  two  allegedly  distinct  sections  of  the  United  Kingdom 
Provident  Institution  as  proof  of  the  relations  of  "alcohol  and 
length  of  life."  This  citation  is  followed  with  this  positive,  but 
none  the  less  dubious,  statement :  "These  averages  have  been 
made  up  from  records  including  many  thousands  of  lives,  and 
there  is  no  doubt  of  their  correctness.  They  have  been  exam- 
ined with  great  care  to  see  if  there  was  any  reason  other  than  the 
use  of  alcohol  why  the  drinking-man  should  die  earlier  than  the 
non-drinker.  No  such  reason  can  be  found,  and  it  is  certain  that 
the  users  of  alcohol  fail  to  live  as  long  as  those  who  do  not  use 
alcohol,  because  the  alcohol  weakens  and  injures  the  body." 

Having  already  discussed  at  some  length  the  real  value  of 
these  same  mortality  statistics,  a  restatement  of  my  reasons  for 
dissenting  from  this  text-book's  conclusions  would  here  be  en- 
tirely unnecessary.  I  should,  however,  like  to  know  precisely 
what  the  author  of  the  text-book  means  by  his  phrase  "the 
drinking  man,"  whether  he  believes  that  all  drinking-men 
of  any  given  age  have  a  common  death-rate,  however  much  or 
little  they  individually  drink,  and  if  his  flat-footed  assertion 
that  "it  is  certain  users  of  alcohol  fail  to  live  as  long  as  those 
who  do  not  use  alcohol"  applies  to  the  "rarely  use"  variety  of 
the  New  England  Mutual  Life's  policyholders  which  was  de- 
fined by  the  Company's  Medical  Director  as  "the  man  who  says 
that  he  perhaps  twice  a  year  at  a  dinner  drinks  two  glasses  of 
champagne." 

Here  is  confirmatory,  conclusive,  and  thoroughly  up-to-date 
evidence  of  the  truth  of  Dr.  Duncan's  statement  in  his  paper 
before  the  Insurance  and  Actuarial  Society  of  Glasgow  which  I 
have  previously  cited,  to  the  effect  that  "one  of  the  worst  of 
them  (the  characteristic  failings  of  teetotallers)   is  a  habit  of 


30  DEATH-RATES  OP  ABSTAINERS  AND  NON-ABSTAINERS 

exaggeration  and  intemperance  in  their  statements  about  mod- 
erate and  temperate  indulgence  in  beverages  containing  a  per- 
centage of  alcohol  and  about  the  evils,  often  imaginary,  of  such 
moderate  indulgence."  In  my  judgment,  this  exaggeration  and 
intemperance  in  the  temperance  teachings,  and  the  methods,  of 
the  total  abstainers  and  Prohibitionists  are  largely  responsible 
for  the  obvious  fact  that  Prohibition  has  utterly  failed  to  de- 
crease not  only  in  this  country,  but  apparently  throughout  the 
civilized  world,  the  per  capita  consumption  of  alcohol. 


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BERKELEY 

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